Tracey Cleantis, LMFT

How to Find the Best Therapist for You

Seven tips on finding the best fit for you.

The first time I went to therapy, my parents chose a psychotherapist quickly (an easier decision than which mechanic to use). The way they found this nutter-butter-can-of-cashews: My first pediatrician didn't know what to do for my all-night, every night nightmares, and so he sent me to a therapist. He thought she was good because of her seemingly impressive pedigree. And let me let them tell you as they told everyone who asked: "She did therapy on the Prime Minister from Israel." Even at age 10, I found this bit of information troubling and logistically dubious, as we lived in a beachside suburb in Los Angeles and the Prime Minister from Israel lived in Israel.

Here are a few examples of her wacky behavior:

1. She ate cottage cheese with her mouth open during our sessions. I feel sure that her mouth full of curds gave me more nightmares.

2. She read her mail during our sessions. While I get that my 10-year-old chatter was not very stimulating, she was getting paid to listen to me and not to read what the latest edition of Readers Digest said about how to declutter your desk. Good God, do I wish I was making this stuff up.

3. I have since learned that she asked patients for rides to the airport. She never asked me for a ride, but I was only 10 and I didn't even own a bike.

I thought, as a public service of sorts, and because I am a therapist and I write about being in therapy, it might be a good thing if I shared some thoughts about picking a therapist—should you ever find yourself in need of one—as they can be harder to find than a good mechanic.

1. Ask friends and family

Ask friends who are in therapy if they like their therapist. If they do, find out what it is they like about them and ask your friends to ask their therapists for referral lists. I have never gotten a good referral that way, but I have given out some good referrals because friends have asked me if my therapist knew anyone for them.

Source: Antonio Guillem/Shutterstock

If none of your friends are in therapy or if they tell you that they don't like their therapist and how they keep going just because they don't want to hurt the therapist's feelings, it's best to get a referral elsewhere. I have gotten my most of my referrals by calling institutes (Jungian, Psychodynamic, Psychoanalytic) for therapists in my area. That said, you don't want a therapist who is convenient—you want a therapist who is good. Good and convenient do not often go hand in hand. I could have a therapist that is only five minutes from my house, but I believe Igor is worth the hour drive. And, I find the drive home to be an important time to process my feelings.

Many institutes have a service in which a clinic director will do an intake and determine what therapist in the community might be a good fit for you. That is a wonderful way to find a therapist if you don't have a referral source.

2. Shop online

While I have never found a therapist online, I do have an ad on Therapist Finder. And I do think (in the online age) it is likely to find a therapist on Psychology Today's Therapy Finder. When therapist shopping I would look for therapists who are not selling themselves but rather those telling you about their work and their philosophy of working with patients.

3. A picture tells a story

Take a look at therapists' pictures on Psychology Today's Therapist Finder. Red lights for me: Therapists who use glamour shots or whose portraits seem in any way seductive. I would also steer clear of therapists who use a photo of themselves partaking in a favorite hobby or recreational activity. If you have any doubt about a therapist based on photos, I would listen to your intuition. See if you can find someone who you could easily sit across from. I am not saying your therapist needs to look like a supermodel; you just want to look at the therapist without feeling any concern or apprehension. I would heed any intuition.

When choosing a therapist, almost all people have an instinctive idea on gender they would prefer to work with. For me, my default therapist choice is always male which, in fact, comes out of my relationship with my parents. I don't think there is a right or wrong when it comes to choosing which gender you prefer to work with. However, I think it can be clinically valuable to notice which gender you absolutely wouldn't want to work with. I would make note of that and let my therapist know about my strong feelings of "no way" when considering a certain gender for a therapist.

5. Theoretical orientation

This one is really tricky. There are many theoretical orientations and I certainly cannot explain them all in one single post. Here is what I can say in a huge and gross oversimplification:

If you believe there is an unconsciousmotivation for your behavior, you might want to go to a psychodynamic therapist.

If you want to change your thoughts and you think doing that will change your life, and you don't believe in an unconscious, then you might want a cognitive therapist.

If you don't ever want to talk about mom and dad and you only want the here and now then maybe narrative, behavioral, or solution-oriented therapies are something to consider.

If you want to work on your family and not just on you, then try a family-oriented systems therapist. Let me say again that was an enormous oversimplification. If you want to know a little more read this.

If you still have no idea at all about what orientation you might want, I would then call the referrals you found and ask about orientation. If the therapist says, "I am an existentialist" and leaves it at that, then have her explain what that means and how you would experience that orientation. Keep calling until you find someone whose style resonates with you.

6. Call them

When you find a therapist to call, then call. It sounds easier than it is; I have had the numbers of therapists in my possession for weeks before I dared to call. Once on the phone, I had questions handy:

Where did he go to school? The best schools don't necessarily make for the best therapists. When asking this, I am not looking for a certain answer. I just want to know for sure that it is an accredited school and not an online coaching certificate.

What is her specialty? I tend to be wary of people who specialize in everything. One can't be all things to all people.

Has he worked with people with your issues? On the phone, share a little about your presenting issue and see how the therapist responds.

What is her training? If she says she is trained, find out if it was a one-day seminar in EMDR and, or, if she took a three-hour online course in psychoanalysis. If she calls herself an expert in a modality after such a short training I would likely hang up and move on to someone with a little more experience.

Is he licensed? If he says that he is, I would still look up the license and make sure. There are people (people I know, people I went to school with) who don't have a license and they are practicing. And it makes me wackadoodledoo. I have too big of a Superego to ever trust someone who would work outside of the law. Once you are sure that he actually has a license, I would also look on the state licensing boards to see if there are any infractions against the license.

Are they now, or have they ever been, in therapy? This is a big one. Do not, repeat, do not, get into therapy with someone who hasn't done her own work. Seeing a therapist who doesn't do her own therapy is like going to a priest who has no relationship with God. This is a big one for me. Unless one has done her own work, she is likely to have issues that create an increased chance of boundary issues, unmanaged counter-transference, and blind spots.

Before I set up the appointment, I would find out the fee and discuss sliding scale or insurance. If you like everything about the person, but the rate is more than you can manage, I would share this. If he can slide no lower, then I would ask for referrals. He might know someone who works like he does at a lower fee. That said, cheap is not always better.

If you don't have insurance and can't afford the fees: see an intern at a clinic. The great thing about working with interns is that you get two therapists for the price of one. You get the intern therapist you are working with and the supervisor who is supervising. Training institutes usually have interns on staff that are available at very low rates.

For years, I saw a Jungian analyst for the embarrassingly low fee of $25 a session. He saw me at that low rate because I couldn't afford more and because he was doing pro-bono work for the institute as a way of giving back.

7. Notice

Notice how you feel on the phone with the therapist. Nervous was how I usually felt on that first call. I rarely have had an immediate "yes" feeling when I talked to a therapist on the phone. I usually felt a little weird and awkward. You may feel differently. Just notice how you feel on the phone and after you have made the appointment. Also, if you are doing psychodynamic therapy, you might want to write down any dreams you have had once you have made the appointment.

On your first appointment, notice how you feel when you are in the room with your new therapist. Do you feel heard when you speak? Notice how you feel in that person's presence. Notice everything. You might not decide on the first session if the therapist is for you. It may take some time to determine if you have picked the right therapist. If you decide that it isn't a good match, then you don't need to go back. It is best to tell the therapist what it is you're looking for and why she isn't the best fit for you. The therapist might have some ideas for a referral that would work for you. And sometimes that desire to not go back is motivated by some more unconscious anxieties about being in therapy. Best to discuss those, too.

Also notice if there are any red flags, any ethical, boundary issues, or cottage cheese eating that starts to arise. If there are, it might be time to pick another therapist.

My Jungian therapist was referred to me by a friend's Adlerian therapist. And interestingly, I knew she was the one when I spoke to her on the phone. I always tell friends to talk to people on the phone first but I never thought to check to make sure they're licensed and don't have any infractions.

"Red lights for me are therapists who seem to be using a glamour shot or whose portraits seem in any way seductive."

Bunk. My wife helped me find my therapist. Her on-line portrait was rather seductive looking. She was even more attractive in person. Sure, initially the relationship felt a little awkward, but I am there to listen to her, not look at her. I have made great progress in therapy and have no desire to change to another therapist. I see no reason why this should be a "red light." You are judging a book by its cover.

However the title for the article is a large font bold "How to find the BEST Therapist for you". You're also posting your opinion in an advice article.

I am a person who cares about maintaining a physical appearance and that line has offended me. At the end of the day I don't care what my therapist looks like, I'm more focused on how I can identify with them.

After 2 not great experiences with therapists that were recommended to me, when it was time for me to find a new therapist, I decided to do my own search online and couldn't be more pleased with the results. I have found the most amazing therapist!

It helped that I knew what I didn't want, and also had some idea of what I did want. I actually used the Therapist Finder on the Psychology Today website. I selected the nearest major city, figuring that it would give me the biggest selection. Narrowed first by gender (female), then by education levels (I wanted someone with a PhD). Then, I opened each remaining profile in a separate tab of my browser. I started eliminating based on years of experience, what they said they treated in their practice, their primary client base, and anyone who's profile just sounded too "market-y". I was left with one profile. I checked to make sure she was licensed then emailed her for a phone consult. A year and a half later, I couldn't be happier with my choice.

Why are patients expected to spill their insides to someone who barely talks about themselves? It feels very unnatural. Why can't therapists and patients get to know one another even just a bit like two people in any other relationship would? All of the official explanations for it sound like that's-just-the-way-therapists-do-things.

Thank you so much for you comment, Leslie!! I am actually planning on writing a post about the importance of real relating and the PROFOUND importance of relatedness in psychotherapy. I think that many therapists choose not to relate( and instead guard themselves in theory) is that real relationships are scary and theory can be a way of guarding themselves from it. Your comment is so well timed and has really inspired me to get writing that piece ASAP. Thanks again!

Today I had a final conversation with my therapist I've seen for close to 2 years now. In closing, I said to him "there is to much pain associated with you standing on the sidelines type of therapy and for me right now, I need more." Since this morning I have been struggling to find a place of comfort for making that decision. I have cried, did some belly breathing and stood in the wind to get perspective. Do I feel better? I don't know that I will because he was my first therapist. However, after reading your blog and responding posts, I feel more secure in my decision. I know I will never know the reason my therapist chose to take the position to stand on the sidelines, but I do know, now thanks to you, that the doubt I was feeling perhaps is better looked at in the perspective of "real relating."

Dear Snow: THanks for writing. I am so sorry. Have you ever read anything about Relational Psychoanalysis? It might interest you. That kind of work requires that the therapist truly be related and be in the relationship in a very honest way. Stephen Mitchell and J. Greenberg are the writers who write most on the topic. I am so sorry you weren't able to get what you need with this therapist. I am so glad if this post and the resulting comments helped you trust your instincts. I congratulate you for knowing what you want. I want to thank you again for inspiring me to write a post about relatedness in therapy. I promise to have it up soon.
Very sincerely,
Tracey

So, it has been almost a year and I still think about my first therapist. I have found a "related" therapist and am happy to have her as a therapist. Right now though, she is going on a 3 week vacation and I am having a very visceral reaction to her absence. As much as I understand the significance of my feelings, I am experiencing uncomfort, am angry over their origins, struggling with wanting to throw a temper tantrum during my next session with her, struggling with the anger of the lost opportunity to express the anger when it mattered years ago, and AND am scared of the stage or phase or whatever of my therapy. I am going to miss her terribly and am scared to tell her that. I feel I need her now more than ever simply because of the strong emotional reaction I am having over her vacation. Relatedness is very powerful and effective approach, I just don't know if can continue; I feel my heart may break over the next few weeks.

Do you have a chapter on tapping into that power when the therapist is not available?

So, it has been almost a year and I still think about my first therapist. I have found a "related" therapist and am happy to have her as a therapist. Right now though, she is going on a 3 week vacation and I am having a very visceral reaction to her absence. As much as I understand the significance of my feelings, I am experiencing uncomfort, am angry over their origins, struggling with wanting to throw a temper tantrum during my next session with her, struggling with the anger of the lost opportunity to express the anger when it mattered years ago, and AND am scared of the stage or phase or whatever of my therapy. I am going to miss her terribly and am scared to tell her that. I feel I need her now more than ever simply because of the strong emotional reaction I am having over her vacation. Relatedness is very powerful and effective approach, I just don't know if can continue; I feel my heart may break over the next few weeks.

Do you have a chapter on tapping into that power when the therapist is not available?

In school I remember hearing different professors weighing the pro's and con's of self-disclosure. From my personal experience as a counselor, well placed self-disclosure helps strengthen the therapeutic alliance. I've had numerous comments from clients saying they appreciate that I am "real".

"And, I find the 60-minute drive home to be an important time to process my feelings."

That's a really good point about having some alone time after the session to process thoughts.

I also like your idea of calling and asking specific questions before the initial meeting, then observing how you feel during the first session. I can say that if I'd done these two things I would have eliminated some very bad therapist choices before wasting a lot of time and money.

Thank you Tracey for this article. I appreciate the detailed quality information you share in connection to finding a therapist. I am the first to say I appreciate the way you can write in a way that is 'user friendly' and at the same time intelligent and full of information that is much needed... at least for me.

This is so helpful - I think back when my husband was looking for a therapist, and we took the recommendation of one of my doctors and it was a total bad fit. He could have just called and talked to the therapist and saved a lot of money and time. Also, after that experience I have not been able to get him back into therapy.

And your dead-on advice about that first visit is what I do with my gyn & other doctors - I won't stick around if I feel like just another number trotting through the office, no matter how good the reputation. It seems so obvious, but I once had a gyn who was very nice, but I'd always cry in his office b/c how he said things made me so upset - it took me a while to realize we weren't a good fit!

This is so helpful - I think back when my husband was looking for a therapist, and we took the recommendation of one of my doctors and it was a total bad fit. He could have just called and talked to the therapist and saved a lot of money and time. Also, after that experience I have not been able to get him back into therapy.

And your dead-on advice about that first visit is what I do with my gyn & other doctors - I won't stick around if I feel like just another number trotting through the office, no matter how good the reputation. It seems so obvious, but I once had a gyn who was very nice, but I'd always cry in his office b/c how he said things made me so upset - it took me a while to realize we weren't a good fit!

I'm in an HMO, and the day I needed help I did not get to pick - I got the next available appt. I really thought a male therapist would help me to restore my faith in men. And he really did his best, absorbed a great deal of feedback from me. But, he didn't know the first thing about helping someone who'd been through a sexual trauma (reason for no faith in men). I bought him a book (From Trauma to Recovery, Dr. Judith Herman) to try to teach him....
We both tried to make it work, for too long. Just when I was about to quit, he got a new job. My new female therapist knows what to say, how to help; it is a huge relief to work with her. Her knowledge and training are so much more important than anything else.

This is very helpful indeed. I bet a lot of people never consider half this stuff when they seek out a therapist. I wish I'd had this checklist way back when, when I was a teenager trying to figure things out with the completely ineffectual guy who was "helping" me.

"Also notice if there are any red flags, any ethical/boundary issues or cottage cheese eating that starts to arise. If there are, it might be time to pick another therapist."

Interesting. I saw a young female Social Worker for about 5 months and it was by far the most miserable experience of my life. She never brought cottage cheese into the session but she did bring her cell phone which constantly went off (on vibrate). When I had inquired about how it was disruptive after a few sessions she picked up her phone held it inches from my face, turned it off and violently threw into her desk drawer and gave out a heavy sigh saying in that her cell phone was was "emergency and personal use." Well, isn't that what anyone's cell phone is for? I could only gather she was getting personal calls from a boyfriend/lover for whenever her phone went off she would end the session anywhere from ten to fifteen minutes early.

When I first met her she went on and on and on about her education, constantly pointing to her degree(s) on the wall. For some reason she felt to need to reinform me that she was a licensed therapist and her past history as being one seemed to always pop up from time to time.

Another red flag was how she would sit close to me. As in extremely close. She would pull up her chair and right up next to mine and write notes in order that I would see them simply because I had mentioned I had astigmatism. Why she did this I have no idea other than to see if she was trying to get at some diagnosis by seeing how I would react whenever she pulled this. In retrospect, I thought it was odd if not awkward.

Usually, she was 10 to 15 minutes late for a session, never apologized for it and when the session did (finally) start whatever she was working on in the previous week was dropped and/or forgotten in favor of something new. This was frustrating, exasperating and I felt I was in a proverbial dead end.

As you might gather I did end up requesting to see a different therapist and her reaction to this was strange indeed. She would cite to me that she "tried meeting me halfway" without ever explaining what "halfway" meant. It felt as of she was using a bizarre form a guilt as control and that became worse. Much worse. When I had told her that I could not make a session due to either previous commitment or transportation issues she would suddenly became almost dominatrix-like and shout back at me "NO, THAT IS UNACCEPTABLE!" When I had inquired about why it was "unacceptable" as well she would tell me in endless psychobabble all about the therapist/client transference/counter-transference. Oh, she definitely had some counter-transference going on.

Scary.

It did no good to complain either to her supervisor or the State Board for her eccentric behavior and the experience with her left me (and I know this may sound a but cliche) a bit emotionally damaged. Since last December, I have not been in therapy for it is hard to find one whom I can afford and is a bit more stable in their profession. I write this because your article gave me wonderful insight in what to look for instead of finding out the hard way that is some horrible, horrible therapist out there. Most of which not only need serous therapy themselves but in no way should be seeing people.

Generally, before picking a therapist, I will call a therapist and speak to them briefly to see how verbally expressive they are and how they react to me as an individual. A first impression, after all, is key.

"the embarrassingly low fee of $25" I understand how paying less than the norm for a service can be embarrassing. As someone frighteningly looking into how to find a therapist (I am poor and have no health insurance) this statement made me think I should assimilate to being embarrassed. I assume this was not your intent, but I should say - $25 is a significant amount in a lot of peoples lives. The rest of your article was very informative and helpful.

The therapist I went to opened the door and said I should sit in her office in her home, and excused herself. I could here water running as she was taking a shower. The second time there was a sign on the door to just walk in. She was taking a shower. I never went back.
I have been to 16 counselors, most drop me after 2 visits due to the number of abuses I've had and most can not deal that religion was the cause of most of them!!!!!!!

This is everything I've ever felt when starting with new therapists! There has to be an immediate connection in my gut or I know something's wrong. I've found my best therapists and avoided some bad ones by just following my gut. Also, I'm freaked out because I think that LA county based therapist who eats cottage cheese and brags about her accomplishments was my therapist at one point. When I was a kid. She ignored any opinions I had on her way of therapy and based our sessions off her computer or printouts if she wasn't too busy checking her email. Creeeeeepy. If your kid says there's something wrong with their therapist, LISTEN TO THEM!

Finding your article as I head once again into the maze that is the search for the "unicorn" therapist (one that proves useful), having run the gambit of thumb twiddling unprofessional to lightbulb on, epiphany guiding (rare). Previously having had a near death, out of body, experience thanks to abusive psychiatric care after being prescribed what a pharmacist had to inform me was a lethal cocktail of psychiatric medications sending me into renal failure and eventually cardiac arrest with further treatment. None of these medications which I had ever needed, as I was conveniently misdiagnosed multiple times over several years for more lucrative medications to be legally prescribed for what is descreetly kick-backs from pharmaceutical companies. After enduring these extreme infractions, and others, I have gained lengthy insight into the fields of both psychiatry and psychology and how these professions affect our society today, some detracting and some adding to our understanding of mental health and well-being. Despite my horrendous experiences, still understanding the invaluable contribution a well informed and positively growth enabling therapist can provide I am once again on the hunt for this nearly mythical beast... I say with humor, a trait that has been one of my saving graces in the face of such adversity and near defeat. My life story in many ways has become a cautionary tale for many, and as I have met others who have also experienced set backs due to medical negligence, or the surviving loved ones of less fortunate people, I also believe it is important to be as well informed about the nature of these areas of study as humanly possible to avoid the trappings of a not yet fully developed, or as I prefer to call it, science in it's infancy. There are plenty of charleton and snake oil salesmen who will happily trapse the unsuspecting wonderer into oblivion as there are well meaning and ineffectual duds. We can only do our best to avoid such obsticles by being well informed and this article provides a great jumping off point for the layman, myself included. It is more challenging to distinguish the various modalities of counseling available and what would best suit each individual. I believe in time these issues and major problem areas will be worked out, but ideally to not be traumatized in the process is a matter of awareness, persistence in self care, and self informed seeking. I wish all the best of luck in your searches for the right fit, more difficult than finding the perfect shoes. Do not tread intellectually lightly upon that which may mark your soul.

"You need to see someone about your issues" has been told to me numerous times. The fear of going and the total lack of knowledge on how to find a therapist has been holding me back for years. Your post was one of the first that came up. I'm going to do this! I now have a 100% better idea on what I need and should do.
Thanks you so much!

I wish I'd thought to read this before settling in with my last therapist. My last therapist honestly believed that food additives caused austism and actually spent the last half of our session telling me all about how her theory was 'totally true' and there's 'like totally reports, I'm telling you'. My therapist would also talk about her personal life after I talked about things that had happened to me. And the "best thing" she suggested? That I, a 19 year old guy who had just been sexually assaulted by another gay guy, should visit a gay bathhouse in order to "get over" that sexual assault.

I really appreciate this information on how to pick the best therapist or psychologist. I like that it points out that it might be a good idea to look at the picture and gender of the therapist to make the best decision. I also like the idea of picking one that will let you have a consultation before choosing them. Thanks for the information!http://www.psychologistscounselingbrooklyn.com

Every time I want to discuss abuse issues that occurred in my childhood that involved homosexuals - I find that the idiot I'm paying $100.00 + an hour to is a flaming fag. Either they want to "console" me or are offended beyond making a second appointment at the thought somebody might object to their "lifestyle". Female therapists are no better.

Any way I can find out in advance without stirring up a lot of butthurt? (Pardon the pun)

I had a therapist as a teenager who was extremely helpful (I suffered from extreme anxiety after my parents divorced.)

Later in life I was experiencing other problems and decided to try to find a therapist.

This was the most expensive and exhausting experience. Eventually, after about 1 year I found a young therapist who was so kind and understanding I finally felt a sense of hope.

I would see him on and off over the years. I had not seen him in some time and tried to find him again. I was very sad to discover that he had passed away. He was 51 years old. The person who told me this (a former colleague) told me she felt he was a very gifted healer. I felt so too.

When I got over the shock of this news, I asked if she knew of any other such therapist in my area. She gave me the name of a man she did not know personally, but who had also trained with my late therapist.

I cannot tell you what a horrible experience visiting this Dr.was. Not only did he not help me, but he scared me. After about 5 visits (once per week and none too cheap) he said that he felt I was in trouble and would be dead by the end of the year if I did not begin visiting him more frequently. I was so stunned to hear this. I thought it was very unprofessional and it scared me. I left the office right away.

I calmed myself down and was able to sleep that night. The next day I called the woman who referred him to me and reported the incident. She said she felt it was unprofessional as well. (I did not abuse drugs or alcohol - I do not know why he thought I would be dead.)

Later in the day he called me to see if I was okay. I told him I was fine and told him that I would not be coming back again. He asked me to send a check for the visit. I told him I would not pay him and told him never to call me again. Fortunately I did not die before the end of the year (@ 2005).

I have not been back to a therapist since this experience.

I would like to try again, but in my whole life found just 2 among 20 who did more good than harm. Plus it cost me a lot of money.

I'm trying to find a therapist to help me through my depression. Thanks for the advice about finding out their training and background. Hopefully, I can find a therapist that is well trained in psychology to help me.

I really like your tip about calling the counselor or therapist when it comes to searching for one. I never thought about asking what their specialty is. My husband has been suggesting getting some counselor after we had our second miscarriage this last fall. These tips will definitely come in handy while I search for the right person, thank you for sharing!